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General NPI Number Information
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NPI Number | 1851566723
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Entity Type | Organization
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Legal Business Name | ROBERT AND CHRISTINE CUNNINGHAM, LLC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 140 PORTO SALVO DR
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City | ISLAMORADA
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State | FL
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Zip | 33036-3319
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Country | US
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Telephone | 305-664-0146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 702
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City | TAVERNIER
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State | FL
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Zip | 33070-0702
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Country | US
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Telephone | 305-664-0146
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MRS. CHRISTINE MARY CUNNINGHAM
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Credential | M.S.
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Telephone | 305-664-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH2376
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License Number State | FL
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